Gagliardino, Juan Jose; Calvo, Héctor; Elgart, Jorge; Gonzalez, Lorena; Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina; Dove Press; ClinicoEconomics and Outcomes Research; 58; 7-2013; 337-345

dc.identifier.issn

1178-6981

dc.identifier.uri

http://hdl.handle.net/11336/11251

dc.description.abstract

Purpose: To measure the impact of a Diabetes and Cardiovascular Risk Factors Program implemented in a social security institution (OSPERYH) upon short- and long-term clinical/metabolic outcomes and costs of care. Methods: Observational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female OSPERYH affiliates with diabetes before (Baseline) and one and three years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration´s database. Results: The implementation of the program in "real world" conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRF) as well as a decrease of events related to chronic complications. This improvement was associated to an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRF. Conclusion: The implementation of a diabetes program in "real world" conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRF, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing its costs, our results suggest the need to include management control strategies in these programs for an appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.

dc.format

application/pdf

dc.language.iso

eng

dc.publisher

Dove Press

dc.rights

info:eu-repo/semantics/openAccess

dc.rights.uri

https://creativecommons.org/licenses/by-nc/2.5/ar/

dc.subject

Chronic diseases

dc.subject

Diabetes

dc.subject

Management

dc.subject

Program evaluation

dc.subject.classification

Políticas y Servicios de Salud

dc.subject.classification

Ciencias de la Salud

dc.subject.classification

CIENCIAS MÉDICAS Y DE LA SALUD

dc.title

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina